BERLIN, Germany—Statins may help improve bone healing, according to new research in a mouse model of neurofibromatosis type 1 (NF1). The study appears in BMC Medicine.1
“Our results confirm the validity of the hypothesis that statins have a beneficial influence on defective bone healing in NF1-deficient mice,” conclude researchers led by Mateusz Kolanczyk, PhD, of the Max Planck Institute for Molecular Genetics in Berlin, Germany. “They also set the stage for future experiments aimed at the treatment of focal NF1 bone changes with local statin delivery.”
Is there anything statins can’t do?
In addition to their proven cholesterol-lowering effects, statins are also being studied in dementia, certain cancers, and in autoimmune diseases such as rheumatoid arthritis.
The researchers looked at lovastatin’s ability to prevent pseudarthrosis in an animal model of human NF1 disease. The mice showed tibial bowing similar to that observed in NF1 patients. Mouse legs are not subjected to the same excessive mechanical forces as humans’, so the team also applied a bone injury model. The authors drilled a 0.5 mm hole in the tibia of anaesthetised mice to analyze the process of bone repair process on day 7, 14, and 28 postinjury. The mice that received statin therapy showed marked improvements in bone healing compared with controls.
“Lovastatin appears to accelerate cortical bone repair primarily by enhancing new bone formation within the bone marrow cavity and by replacing fibrocartilaginous tissue in the injury site with mineralized bone matrix,” the authors conclude. “Our results suggest the usefulness of lovastatin, a drug approved in 1987 for the treatment of high cholesterol, in the treatment of neurofibromatosis-related fracture healing abnormalities.”
What’s more, the new mouse model is a valuable tool for the preclinical testing of other candidate drugs that target similar bone problems.
In an accompanying editorial,2 Bruce R. Korf, MD, PhD, of the University of Alabama at Birmingham, wrote that the new report opens the door to clinical trials in humans. “Improvement of bone healing in children with tibial dysplasia would be welcomed given the enormous difficulty in the management of this complication and the severe associated mortality. Whether statins will have other benefits related bone mineral density remains to be determined.”
Jury still out on statins and fracture prevention
Stephen Honig, MD, director of the osteoporosis center at New York University Hospital for Joint Diseases in New York City, reviewed the new research for MSKreport.com.
“Neurofibromatosis is obviously a different model from postmenopausal osteoporosis, but there are a number of retrospective population-based studies that suggest statins may reduce the incidence of fragility fractures,” Dr. Honig said. “However, the small number of prospective trials that have looked at this class of drugs have not confirmed their antifracture efficacy.”
Nonetheless, “the presumption…is that by acting on the mevalonate pathway, albeit more upstream, statins might have an effect similar to bisphosphonates [but] the latter class of drugs, however, are concentrated in bone while the former [is] not and this may limit [statins’] antifracture efficacy.”
References
1. Kolanczyk M, Kuehnisch J, Kossler N, et al. Modelling NF1 tibial dysplasia and its treatment with lovastatin [published online ahead of print 31 July 2008]…BMC Med. 2008. http://www.biomedcentral.com/1741-7015/6/21/abstract.I was reading somewhere this week that statins can raise the risk of cancer and dementia. The jury is still out for me on this one. I used to think this drug would decrease inflammation but it seems it comes with it some negatives that I feel is not worth the risk for me. Also, I find this med extremely overused where I work. Everyone gets put on this med when they come in with any kind of vascular event. I think this is overkill. Kind of like gastric pump inhibitors. I'm going with the fish oil option.
2. Korf BR. Statins, bone, and neurofibromatosis type I [published online ahead of print 31 July 2008]…BMC Med. 2008. http://www.biomedcentral.com/content/pdf/1741-7015-6-22.pdf.